Identification in administrative databases of women dying of breast cancer.

PURPOSE: Palliative care is an essential component of cancer care, and population-based research is needed to monitor its impact. Administrative databases are the cornerstone of health services research. Their limitation is that cause of death is not sufficient to readily classify decedents as termi...

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Publicado en:Journal of Clinical Oncology Vol. 24; no. 6; pp. 856 - 863
Autores principales: Gagnon B, Mayo NE, Laurin C, Hanley JA, McDonald N
Formato: research Journal Article
Publicado: American Society of Clinical Oncology 2/20/2006
Acceso en línea:Ver este registro en EBSCOhost
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        0732183X
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      dt: 2/20/2006
      vid: 24
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      pub: American Society of Clinical Oncology
      place: Alexandria, Virginia
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        atl: Identification in administrative databases of women dying of breast cancer.
      aug:
        au:
          Gagnon B
          Mayo NE
          Laurin C
          Hanley JA
          McDonald N
        affil: Division of Stroke, Rehabilitation, Health Care Services, McGill University, Montréal, Quebéc, Canada. bruno.gagnon@clinepi.mcgill.ca
      sug:
        subj:
          Breast Neoplasms Therapy
          Palliative Care
          Adult
          Demography
          Aged
          Aged, 80 and Over
          Algorithms
          Canada
          Resource Databases
          Female
          Hospice Care
          Hospital Mortality
          Hospitals
          Medical Records
          Middle Age
          Predictive Value of Tests
          Reproducibility of Results
          Retrospective Design
          Sensitivity and Specificity
          Terminal Care
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
      ab: PURPOSE: Palliative care is an essential component of cancer care, and population-based research is needed to monitor its impact. Administrative databases are the cornerstone of health services research. Their limitation is that cause of death is not sufficient to readily classify decedents as terminally ill for the study of the health services they received at the end of life. The study purpose is to develop and test the validity of an algorithm allowing the classification of the decedents as dying of breast cancer (BC), using administrative data. METHODS: Validation was carried out through a chart review of 119 BC decedents extracted from hospital-based databases. This algorithm was applied to 3,384 deceased women with BC representative of the whole population. The effect of the classification by the algorithm was illustrated by the shift in the distributions of age and place of death. RESULTS: The validation showed a sensitivity of 95%, a specificity of 89%, a positive predictive value of 98%, and negative predictive value of 77% for the classification of women dying of BC. Of the 3,384 decedents, 2,293 were classified as dying of, and 1,091 as not dying of BC. Women dying of BC were younger, died less often at home (6.9% v 17.9%), and in chronic care institutions (4.1% v 14.8%), and more often in acute-care beds (69.9% v 57.1%). CONCLUSION: This novel way to classify decedents is conceptually based and empirically validated through chart review and impact on distribution of age and place of death.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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